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Poor oral health and the association with diet quality and intake in older people in two studies in the UK and USA

Lookup NU author(s): Eftychia KotroniaORCiD, Dr Heather BrownORCiD, Professor Sheena Ramsay



This work is licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0).


We aimed to investigate associations of poor oral health cross-sectionally with diet quality and intake in older people. We also examined whether change in diet quality is associated with oral health problems. Data from the British Regional Heart Study (BRHS) comprising British males aged 71-92 years, and the Health, Aging and Body Composition (HABC) Study comprising American males and females aged 71-80 were used. Dental data included tooth loss, periodontal disease, dry mouth, and self-rated oral health. Dietary data included diet quality (based on Elderly Dietary Index (BRHS), and Healthy Eating Score (HABC Study)) and several nutrients. In the BRHS, change in diet quality over 10 years (1998-2000 to 2010-2012) was also assessed. In the BRHS, tooth loss, fair/poor self-rated oral health and accumulation of oral health problems were associated with poor diet quality, after adjustment. Similar associations were reported for high intake of processed meat. Poor oral health was associated with top quartile of percentage of calories from saturated fat (self-rated oral health, odds ratio (OR)=1.34, 95% CI 1.02-1.77). In the HABC study, no significant associations were observed for diet quality after adjustment. Periodontal disease was associated with top quartile of percentage of calories from saturated fat (OR=1.48, 95%CI 1.09-2.01). In the BRHS, persistent low diet quality was associated with higher risk of tooth loss and accumulation of oral health problems. Older individuals with oral health problems had poorer diets and consumed fewer nutrient-rich foods. Persistent poor diet quality was associated with oral health problems later in life.

Publication metadata

Author(s): Kotronia E, Brown H, Papacosta AO, Lennon LT, Weyant RJ, Whincup PH, Wannamethee SG, Ramsay SE

Publication type: Article

Publication status: Published

Journal: British Journal of Nutrition

Year: 2021

Volume: 126

Issue: 1

Pages: 118-130

Print publication date: 14/07/2021

Online publication date: 20/01/2021

Acceptance date: 08/01/2021

Date deposited: 08/01/2021

ISSN (print): 0007-1145

ISSN (electronic): 1475-2662

Publisher: Cambridge University Press


DOI: 10.1017/S0007114521000180


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Funder referenceFunder name
R03 DE028505-02
R592/0717Dunhill Medical Trust